SynthesisThe American journal of medicine2022
Oral Is the New IV. Challenging Decades of Blood and Bone Infection Dogma: A Systematic Review.
Synthesis in The American journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
80 citing papers in PubMed, 3 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Early oral versus prolonged intravenous antimicrobial treatment in children with bone and joint infections: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Practice guidelines for outpatient parenteral antimicrobial therapy (OPAT) in Germany.Infection · 2025Guideline
- Pooled it
- Cefadroxil as Oral Transitional Therapy for Gram-Positive Bacteremia With or Without Non-Vertebral Osteomyelitis: A Multicenter Retrospective Cohort Study.Open forum infectious diseases · 2026Trial
- Using the Comparing Oral versus Parenteral Antimicrobial Therapy (COPAT) Clinical Trial to Influence Institutional Practice Transformation Towards Earlier Transition to Oral Antibiotics.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Trial
- Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement.Open forum infectious diseases · 2024Trial
- Review
- Helcococcus kunzii as a rare etiological agent of spondylodiscitis partially managed with oral antibiotic therapy in a patient with diabetes mellitus: a case report.BMC infectious diseases · 2026Article
- Partial Oral Antibiotic Therapy for Infective Endocarditis: A Practical Review of Current Evidence and Guidelines.Pathogens (Basel, Switzerland) · 2026Review
- Optimising antibiotic switching via forecasting of patient physiology.Nature communications · 2026Article
- An application of hospital at home for precariously housed people who use drugs in a community-based harm reduction setting in Vancouver, Canada.Addiction science & clinical practice · 2026Article
- Impact of Institutional Expected Practice Guidelines on Oral and Long-acting Intravenous Antibiotic Use for Serious Bacterial Infections.Open forum infectious diseases · 2026Article
- Osteomyelitis.Nature reviews. Disease primers · 2026Review
- Reflections on the Theoretical Prerequisites for Initial Oral Antibiotic Treatment for Paediatric Bone and Joint Infections: A Narrative Review.Antibiotics (Basel, Switzerland) · 2026Review
- Implementation of an Early Transition to Oral Antibiotics for Patients With Nonstaphylococcal Bacteremia via Real-Time Stewardship Intervention.Open forum infectious diseases · 2026Article
- Article
- 2023 European Society of Cardiology guidelines for the management of infective endocarditis : Statement of endorsement by the NVVC Full version.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Review
- Azithromycin and doxycycline intravenous and oral administrations before and after prescriber-facing alert for intravenous fluid conservation.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Why we do what we do: a survey of ID providers about oral antibiotics.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Oral versus intravenous antibiotics: Oral antibiotics are more cost-effective and may be safer than intravenous antibiotics for most infections in stable adults.African journal of primary health care & family medicine · 2025Review
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWe sought to determine if controlled, prospective clinical data validate the long-standing belief that intravenous (IV) antibiotic therapy is required for the full duration of treatment for 3 invasive bacterial infections: osteomyelitis, bacteremia, and infective endocarditis.
methodsWe performed a systematic review of published, prospective, controlled trials that compared IV-only to oral stepdown regimens in the treatment of these diseases. Using the PubMed database, we identified 7 relevant randomized controlled trials (RCTs) of osteomyelitis, 9 of bacteremia, 1 including both osteomyelitis and bacteremia, and 3 of endocarditis, as well as one quasi-experimental endocarditis study. Study results were synthesized via forest plots and funnel charts (for risk of study bias), using RevMan 5.4.1 and Meta-Essentials freeware, respectively.
resultsThe 21 studies demonstrated either no difference in clinical efficacy, or superiority of oral versus IV-only antimicrobial therapy, including for mortality; in no study was IV-only treatment superior in efficacy. The frequency of catheter-related adverse events and duration of inpatient hospitalization were both greater in IV-only groups. DISCUSSION: Numerous prospective, controlled investigations demonstrate that oral antibiotics are at least as effective, safer, and lead to shorter hospitalizations than IV-only therapy; no contrary data were identified. Treatment guidelines should be modified to indicate that oral therapy is appropriate for reasonably selected patients with osteomyelitis, bacteremia, and endocarditis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.